The Ladder Myth
For those that don't know me and aren't familiar with my ladder prowess, I need to debunk the ladder myth. The myth has me standing on top of my Christmas Lights Ladder Configuration which is simply not true.
Day one - Sunday, January 11 3:00pm
Ladders are fine, harmless even. It's the decisions that people make on ladders that suck. And for all of you naysayers out there, I am not the poster child for the top step of the ladder. I was able to do this while climbing less than half way up.
Here's a diagram of my garage.... | | | | |<--------|------- the loft support | \| | |========\<--------|------- the loft floor | \<-------|------- the 10' ladder leaning against the loft | \ ]| | \ ]<------- the 6' ladder in its stored position | \ ]| | \ ]|<------ the garage wall |______________\__]|
I lean the ladder in the garage from about a foot away from the base of the wall toward the center of the garage and against the loft. From there I carry the Rubbermaid boxes up the ladder and toss them up onto the floor of the loft. What's not being said here is that in order to climb the ladder whilst carrying a box, one must have two hands on the box and no hands on the ladder. Maybe my Mom won't read this.
Of the five boxes total I was on the forth, about halfway up the ladder when I staggered and lost my balance. I peered over my shoulder to judge the distance to the wall, determined it to be reasonable and let myself tip over to the wall leaving me standing on the ladder, leaning against the wall, and holding the 40lb box.
I assessed my situation and noted that there was an additional ladder in the folded-up position but also leaning against the same wall that I was - no problem, adapt and move on. So I put a foot on that ladder, leaned back into the center between the two ladders and reassessed. "Good shape" comes the response so rather than abort and climb down, I go up.
When I got to the rung that needed to be on I heaved the box over my head and missed. It was when I took another bite and kicked off of the weak ladder that it gave way and rocketed out of the way.
My problem is that on the way down, my foot catches box five and stops descending. Me and the box in my hands continue descending and when the box met my knee, we crushed 1) the leg, & 2) box five, and in that order.
I landed sitting on the step that leads from the garage to the house with my back to the closed door. As soon as the leg broke I knew that it was in trouble - it didn't go numb but it went something and I grabbed it.
Two things happened then. First, was the debris that I had caused, like the ladders, the boxes, and the collateral stuff that got hit by said debris, continued to rain down. For 10 seconds (it just seemed like a minute) the ruckus was absolutely deafening. With the six foot ladder sliding across the floor, the box I'm carrying bouncing off my knee and coming to rest on its side, the box that I hit on my way down uncompressing and shattering as I feel off, me landing against the door, the 10' ladder pirouetting in the middle of the garage and when it finally curtseyed, it crashed into some shelving that had mason jars (candle hurricanes) sitting on top so they then tipped over and rolled to the edge before falling the seven feet to the concrete floor. One at a time, for a total of 73. Or, just three.
The second thing was the leg - it was definitely in distress. I was sitting on the step with my right (broken) leg bent, my right foot sitting on the floor, and both hands around my thigh. My left leg was straight out in front of me. I took stock of my other body parts, assessed all of them as good and looked at the leg.
The bone was sticking out of the leg and that is about the strangest thing that I've seen. It wasn't bleeding enough to worry about so I concentrated on keeping it off of the floor and out of the debris.
Jer, happily vacuuming inside, happened to turn off the vacuum in time to hear the rain and ran to the door and tried to open it but that wasn't going to happen and I couldn't begin to speak to tell her that I was okay.
[Weeks later, after speaking with both adjacent neighbors, I've learned that nearly everyone in the small neighborhood heard the rain.]
She went out the front door and ran around to the garage. She couldn't see the leg, just that I was holding it, and asked me if I was okay. I answered "no" so she asked if she needed to call 911. When I didn't respond, she made the best decision of the day to be made in the garage, and went inside and called 911.
I missed the photo op with the seven Firemen and my Wife in the garage.
The Firemen were actually impressed with the break. I think his response was "I seen a few compound fractures and that one is a nice one. That was after he was unable to hide his grimace :-).
I was conscious and coherent the entire time and they kept asking me about pain and kept grimacing when they looked at it. They finally stopped believing me that it didn't hurt and gave me some morphine. An impressive "stick" by the Fireman - he got it the first time and as it turns out, it lasted until Wednesday.
They cut the laces and removed the shoe, spit the pants leg and put the leg and the foot in a cardboard splint, just like the box that you get long-stemmed roses in. Then six of them grabbed different parts of me and lifted and carried me to the gurney so they could roll me out.
The $55 Oxygen hit
We cruising down the road and I'm finding the "see where you've been" perspective very interesting. Not because I haven't been down these roads before or don't know where I'm headed but because we're in an ambulance. Not everyone gets to ride in an ambulance. So, we're chatting and it occurs to me that there are two of them with whom I'm speaking, not the one that I expected. They're both in back with me. So I ask "Wait! Who's driving? There are two of you." The one EMT looks at the other EMT, then he looks at me and says "Give him some oxygen." We rode the rest of the way to the hospital in silence. Maybe they don't like patients that remain conscious. Or maybe they didn't know who was driving.
San Dimas Community Hospital (SDCH)
You definitely want to arrive at the Emergency Room in an ambulance. I've walked in once or twice before and now that I've arrived in an ambulance. I'm prepared to state "pay the $1200 and call the ambulance for your trip to the Emergency Room. Not to mention that arriving in an ambulance gets you "rock star" status.
The Emergency Room
Nice place with an interesting outlook on privacy. You can draw all of the drapes that you can find but it doesn't change the fact that you are still less than three feet away from the lightweight next to you that is getting his extremity stitched up that's screaming like a baby. Seriously, the concept works like a tried and proven concept allowing the Emergency Room to operate like a finely tuned machine. They can shoot an xray and ask medical history questions of the patient at the same time. They can draw blood, take an EKG, mop up dripping blood, and dictate what you had for lunch to the Doctor still in his car simultaneously. It's an impressive sight.
I enjoyed my stay there. I had two students drawing straws to see who gets to give me an injection, a nurse who is clearly a San Diego Chargers fan, and a dozen or so folks who dropped by to see the bone. They couldn't have been friendlier to my Wife and I. I just need to find the Nurse that took this same picture but with a real camera, not a phone.
The Surgery Suite
SDCH doesn't schedule surgeries on the weekends so I got an interesting insight into the suite and its setup. They roll me in as soon as the team is assembled and I get to watch as they prep for surgery. This is Golden Globes Night so there's not a lot of chat or banter. I'm pretty much the only one talking but that doesn't slow me down. 10mg of morphine goes a long way. As I'm watching they get a quorum and decide to move me from the gurney to the table. I look at the size of those interested in moving me and politely offer to move my self. I mean, it is just a broken leg. Shortly, the Doc slides the xrays in to the viewer and we discuss our plan. It was during the discussion that the Anesthesiologist apparently decides that we're not paying enough attention and he pulls the plug. None of that "let's count backwards" stuff or "here we go" chat - just lights out. Maybe I wasn't really all that big a help.
Now, I'm the first to admit that I'm on some serious meds but I'm pretty sure that the Nurses decided that 1) I was there long enough, 2) that they were ready to split and so 3) it was time for me to WAKE UP. Do you think maybe that they're fans of the Golden Globes? My recollection of the wake up was of someone was shouting, not necessarily at me, but that as long as I was awake it must be time to move on.
Who's in the cheap seats? We've got three beds in my room and one tv. Only three days from now, when I get to cruise the halls on crutches, do I notice that most of the other rooms have flat panel tvs mounted one per bed. We've got four days to figure out what's going on outside my 10 by 20 foot world late in the evenings. Granted I'm in a morphine haze but I notice that there is quite a bit of racket and rolling equipment in the hallway late at night. Is it real? Is someone harvesting patients? Has anyone noticed? Am I next?
Day Two - Monday
Jer visits at 7:00am and stays all day. The Doc visits during his lunch rounds and when he comes in we get our first look at the wound. There's a door cut in the cast so that we can change the dressing. It's swollen, bloody, throbbing, and shiny with pins sticking out. I'm not sure what I think about the sight. The wound is open in the center so that it can drain while it heals. Both ends of the wound are stapled closed but at this point, it's tough to tell the difference. The cast has my toes sticking out and stops just short of the knee. Plus, it's fiberglass - how cool is that. The dietitian visits. He's got a tough job. He get's to come and tell me that according to my height and weight, I'm obese. He's correct of course but I don't think that make his job any easier. Ms. Health Plan visits. She becomes a reoccurring character but I'll be honest, I don't know why. The one topic that she and I discussed never got resolved so, if I was paying her salary, I'd have her explain just exactly what she does all day. Crutches was the subject and why I didn't have any because no one could figure out who was going to pay for them. Jer gets rescued with a to-go cup of "coffee" and Mr. Morphine can't quite put all of the pieces together. How do they know how she takes her coffee?
Day Three - Tuesday
Jer visits at 8:00am and leaves around 12:30pm. The Doctor visits shortly after Jer leaves. He pokes and prods, likes what he sees and tells me that I can go home tomorrow if this continues. I ask the Doc if I can get out of bed and he seems surprised that I haven't yet. He says he'll write the "get out of bed" order and four hours later when nothing has happened, The nurse assures me that the Doc wrote the order but Rehab never shows.
Day Four - Wednesday
Jer visits at 7:30am and leaves about 9:00am. Good thing that she didn't wait because the Doc never shows. Probably on purpose so I can't whine at him. I guess this means that I'm not going home today :-(.
Hospital rehab shows and brings a loaner set of crutches so it's off to the gym for a little stair workout action. Since I live in a two story condo the current thinking is that I may need to go to a short term care facility rather than home since I need to climb stairs to live in my house. We reassure the powers to be that I'll be okay at home and I can sleep on the couch. Whew, that was close! Ms. Health Plan is back and STILL can't figure out who is going to pay for the crutches so the Hospital rehab plan has ground to a halt. WTF? I borrow a set from my boss to resolve this unsolvable healthcare issue. Bill brings me his hand-me-down crutches so I can at least go home when the times comes.
Day Five - Thursday
Today's the day - Home from the hospital! The Doc comes in early and we get another look . I get to meet the Charge Nurse, learn about "compartment syndrome", get my obligatory flu shot, and a wheelchair ride.
Day Six - Friday
Franky visits in the morning and decides that the big red leather chair in my front room will never do. He's got a recliner in an office at home that is currently considered "spare" and he's bringing it over. If I don't like it I can cut it up for firewood.
Lunch with the Boys at Pickup Stix. This is my first venture out with a destination other than a bed. We traveled at the same time as the funeral for the families that died on Christmas Eve when the ex-husband visited in a Santa suit and shot and killed nine people at a party before killing himself. The funeral was at the Catholic church here in town and the local Cardinal attended drawing one large crowd. So large that an acquaintance (friend of a friend) who was a friend of the family with the loss was unable to attend the funeral because he didn't have the proper credentials. The story that I'm trying to tell here is that we wound up in the middle of one massive police escort that closed entire streets making traveling from one side of the church to the other, well, difficult. Spending the hour at lunch wound up taking me down for a day and a half.
Day Seven - Saturday
I'm not really moving very far or very fast today. Yesterday's lunch outing did some serious butt kickage.
Week Two - Sunday, January 18
The spare recliner arrives and I've got the perfect place for it - in my office at work.
Doctor Appointment. Getting seated on the table took longer than the appointment itself. Cut the tape, open the door, yank the dressing out, poke, prod, eww and ahh, shove a new dressing in, close the door, and tape it closed - done. See you in a week. There's a door cut in my cast so we can change the dressing but it's not quite big enough to get all of the staples so the plan is to cut a larger hole next time.
Sitting on the table in the Doctor's office brought home the fact that I had indeed landed on my tailbone in the garage. Nine days later, this is the first time that I've sat on anything that wasn't completely padded and man, can I feel it. I'll just lie here on my side, if you don't mind.
Last pain killer today - on with life!
Back to work! Okay, okay, it's just part-time but just the same. I might as well be answering the phone or emails while I recover rather than just lie on the couch. Besides, sitting at home eating the goodies is just going to make me fat. You counting the empty sticks?
Week Three - Sunday, January 25
Doctor Appointment. We cut another, attached hole so we can get the staples in the big wound removed and we took a couple of xrays. Whoa. File:Hole.jpg
There's a second incision (with no cut-out) on the outside of my leg where they put a plate, some screws, and some pins to put the fibula back together and those staples will remain until we cut this cast off, probably in four weeks. There will be another cast put on then but he doesn't want to uncast the tibia at just 17 days, even just to remove the staples until there's more healing. Ultimately, the screws and the plate will stay and all of the pins will come out.
Week Four - Sunday, February 1
This is the first week that I've really noticed the Pin sensations. Now that the leg has both atrophied and is no longer swollen, it can move in the cast. As the pins move along the inside of the cast the sensation is very strange. It's not one of pain but more of, well, I can't really explain it but it has to do with the fact that the pin traverses the leg through the bone. I can hardly wait to see what happens when the Doc takes them out.
Week Five - Sunday, February 8
Different Pin sensations this week. More of a deep rooted thrill that is a cross between a tickle and pain. Don't let your mind unfocus here :-).
Up the stairs! I'm moving out of the Living Room. I still bathe in the kitchen but I can shave in the bathroom and sleep in my bed. I can't seem to sleep more than two hours at a time but that's probably just the matter of the fiberglass cast and all that hardware rattling around inside.
Out to lunch for Valentine's Day to Cafe Allegro. I'm still in shorts so lunch tends to be a little less formal.
Week Six - Sunday, February 15
The swelling is down in general and after standing or sitting with the leg down for extended periods of time seem to leave the leg in pretty good shape.
Went to the market with Jer. This is my first real session where I'm on my feet for any period of time. We spend 30 minutes or so and then home to the chair.
Went to dinner at Casa Del Rey. Alright, that's probably not the best use of my first restaurant dinner but...
Check me out - that's the BBQ that you smell.
Long time friends the Krekelers come for dinner, bring pizza, salad, ice cream, and plates.
Week Seven - Sunday, February 22
Extended spells of having the leg down still cause some swelling. The swelling is quick to drain once I get the leg elevated.
Doctor appointment today. Check out these xrays I point at the bone fragment in the fibula that looks like he found it left over on the table and he (the Doc) says "that's fine." As a matter of fact it doesn't matter what I point at, he says "that's fine." Turns out, he _only_ cares about the joint surface. He takes his time and points out how nice and smooth it is. I ask "is that because you're that good?" He smiles and responds, "yes." Even the Man of Few Words has his moments.
New plan. The Doc says "I'll see you in four weeks" and then contemplates his thoughts. "How long has it been?" he asks. I answer with "six and a half weeks" so he ponders some more and asks "make it six weeks and we'll take everything off" By now I'm familiar with the Man of Few Words. "Just exactly do you mean by 'everything off' I ask." We'll cut the cast off, xray it and then either send you home or we'll put another cast on it. May we'll take the pins out. That clarifies things. doesn't it? :-)
We're going out to dinner for my Mom's birthday. All my girls are there and we have a nice, pleasant evening. Cafe Montclair is one of our favorites and a real jewel in the rough. If you hang in the I.E. be sure and stop by - Dennis and Monique will welcome you with open arms. All of the pictures turned out pretty dark but these two are okay. The Birthday Girl 100px and P & J
Week Eight - Sunday, March 1
We went out to lunch today and then to Barnes & Noble with a trip next door to Best Buy. Okay, that did it! Back to my chair.
My publicist really earned his keep today. He (Warren) came up with a great idea of keeping the large screw when it comes out and making it into a paper weight. Damn, I didn't even think that he was paying attention.
Off to Yord's for dinner. It's a little cool to work on my single-match bonfire technique so I'll forgo any outside activities.
Dinner at the Kelly's this evening. Jer's still not letting me drive :-(.
Week Nine - Sunday, March 8
No real pain associated with the break anymore. No pin sensations or twinges. I can sleep on my tummy pretty comfortably these days.
Week Ten - Sunday, March 15
Another week of healing. I'm spending more time standing, walking, and upright in general. There's a fair amount of swelling during the day but it's pretty quick about going down once I get it elevated.
Whoa! Is that P at the movie theater? Hot diggity, the Kellys went out with the Kellys to see Duplicity. Warren prides himself in a challenge and this was no exception. He shows up with a picnic chair, a camp stool, a theater Manager walk-thru, and a reserved parking spot right in front of the door. How could I say no? Needless to say, the evening came off without a hitch - personal pickup at the door, private seating in the theater, the movie, awesome dinner, and delivery back to the door. What a way to roll. Yea, that's right, that's my pillow.
Week Eleven - Sunday, March 22
Still healing in good shape. The leg is small enough that it feels like I can slip it out of the cast when the swelling is down. If it weren't for the dangling pins and the fact that I'm not 17 anymore, I'd try to slide that ugly thing out of there. I don't think that the "man of few words" would appreciate me showing up two and a half weeks early with the cast under my arm to see if he has any good ideas on just how we're going to get the foot back in the cast. Let's chat again in a couple of weeks :-).
Week Twelve - Sunday, March 29
The leg feels good. No pain associated with the break, screws, pins, cast, or of life in general. A couple of twinges let me know that there is still a reason for the cast but that's it. The cast hasn't fallen off yet so I can still go the Doctor's office with my head held high. I can't buy a signature on this cast - I managed to threaten one of my girls to sign it - but that's it. Even one of the guys that came to the Training Class said he'd sign it and didn't.
Is that P behind the wheel? I finally talked Jer into letting me get behind the wheel of her car. My car, with a 5 speed, was an easy decision but her car, that's a different story. I'm a little jerky driving with my left foot, mostly with accelerations but braking can be exciting too.
Have you heard of HIPPA? It's alive and well in San Dimas. Jer goes to the hospital for some test and finds herself in Radiology. I had briefed her about obtaining copies of my xrays taken in the Emergency Room, specifically about finding out the steps that I would need to go through in order to get the copies. So what happens? That's right, she shows up with the xrays. Whatever. These pictures are tucked back in the Emergency Room section.
My convertible has a plastic rear window that folds in half in the down position and since I put it up and down regularly, it only lasts five years or so. Well, it broke the Friday before I broke my leg and has been resting comfortably in the garage. Since I _could_ be back driving here in a couple of days, Warren found me a new upholstery shop after my last shop seemed to disappear since the last window replacement. I tried a local guy but he didn't really want to touch the window - more than happy to replace the top, but after a lengthy huddle with everyone that they could round up, opted to pass on the window. So, we're off to Raul's Auto Trim in Ontario for a new window installation. Raul busted out a great job on the window - on budget, ahead of schedule - I'm definitely going back for any more work that I need.
P and J travel to Upland and dinner at the Artura's. What's that say about my alcohol consumption when all of my friends are literally stunned when I show up and drink diet coke. Hmmmmm.
Week Thirteen - Sunday, April 5
Lot's of hype regarding the Doctor visit this week. Stay tuned for some new pictures.
Wednesday - That's one ugly stump
Off to the Doc's. I've known for some time that the cast saw is the Doc's favorite tool. He has hardly been able to contain himself when presented with an opportunity to fire it up and today was no exception.
I'm pretty sure that the Man of Few Words would be upset if he knew that I got this picture. This is his 2nd favorite tool and maybe his secret weapon. Would you be surprised if I told you that the pins came right out when he used this? Yea, me neither. We took a close count and realized that there was one that had disappeared but don't you worry your pretty little head because with this secret arsenal of goodies, the Doc was able to locate it and yank it out by the roots. I never even lost consciousness :-).
I'm slated to go back in four weeks to schedule an out-patient surgery to remove the large screw. I begged him to snatch that bad actor out right here in the office but he insisted that there might be a little too much digging around for that but I do believe that was a smile that crossed his lips while he contemplated the thought.
Having the cast off is a mixed blessing at this point. I no longer run the risk of scratching up the furniture but I can't comfortably rest that pudgy thing on the floor anymore. I can take a shower now but where do I put the wet chair when someone else needs to use the shower? Such problems.
Who would have thought that showing up to work in long pants for the first time in thirteen weeks would be such a big deal? Man, am I taking some heat.
Is someone having a birthday? Oh, you shouldn't have! Back to Cafe Montclair for another Birthday dinner.
Okay, you're just being lazy now. It's been three days with no cast and I haven't done anything about rehab. So, it's off to L.A. Fitness to join so that I can swim in the lap (not jacuzzi) pool. I may have forgotten just how far out of shape I am.
Week Fourteen - Sunday, April 12
It is all about getting the swelling out of the leg, ankle, and foot now. A little massaging seems to help and to be honest, the little bit of exercise that I (the leg) got in the lap pool seemed to help quite a bit. Did I mention how nice it is to be able to sit in the tub?
Today was my first visit to the gym to splash around in the pool. It's not pretty but I can crank the length of the pool complete with a kick turn for the return. I made it six lengths before I died. The crutch tips get decent traction on the deck but the one foot between them is a slippery fool. I haven't gone down yet but that's just a matter of time. Crawling from the crutches across the deck to the pool reminds me a beach exit from a scuba dive - just hope that no one is watching because there are zero points for style.
Let me tell you a ladder story :-). I haven't been up in the loft since the 11th of January and as you might imagine, we have some stuff up there that you need to carry on here in the house. Well, the weather is warming up and Jer is looking for a lounge chair for the patio. Where do you think that might be? That's right! So Jer enlists one of here buddies (I'd better check with her before using her name) who says "ladders don't bother me, I'll get up there and get it for you" and off they go. Relax, no one was injured in this particular story. Up the ladder goes Kelly (oops), grabs the lounge, passes it down, and then tries to get down. Don't worry, she was able to crawl down unassisted with everything intact but maybe that was a little higher that she originally thought.
Bill (the guy that decided to keep me employed even though I work from a recliner) has decided that we're taking the show on the road again. I normally do some traveling for Customer visits and trade shows this side of the Rockies. Obviously I haven't been doing much traveling, unless you consider the two miles between home and work traveling, but with this news, we're getting the band back together. On Monday the 27th we're driving up to Central California to visit a couple of Customers and demo a third on our NOC system. I think that he even got me a handicapped room for the overnight stay.
Off to Cal State University, Fullerton (CSUF) for the first OCLUG meeting that I've been to in a while. It was definitely good to see all my buddies again. I walked in only to be greeted by the group that had just finished reading this wiki. That makes it tough for me to tell stories when the tellees have just read all the punch lines.
Week Fifteen - Sunday, April 19
The swelling is down so that you can actually see the toes separate when I wiggle them. There's still not enough motion in the ankle to walk if I were allowed to but it is improving. The toes are not uncurling toward the shin at all and until they bend backward I won't be able to walk. In the ankle itself I've got almost four inches of motion up and down and maybe two or three side to side. There's no pain anywhere to touch but it's tight and swollen right at the ankle and across the foot. The swelling in the lower leg is receding and the foot is getting smaller but the shoe is still not going on.
I returned my office to a regular office today. The recliner is still in there but it's over out of the way and I'm back sitting in a rolling desk chair. I was getting pretty difficult to accomplish anything that resembled real work when anytime that I needed to type or sit I had to recline and set everything in my lap.
Week Sixteen - Sunday, April 26
With the leg down more these past few days the swelling and overall pudgyness of the foot is up. I'm resting the foot flat on the floor and even on the ball when I sit at the desk trying to force some bend into the piggly-wigglies and the ankle and that doesn't seem to be helping the swelling any. I noticed that with my ankles crossed the swollen foot gets a dent that stays for five or six minutes where my other heel was resting. The motion is better in both the ankle and in the toes. I have a small rash in a few areas that were covered by the cast but I've almost completely ruled out swine flu.
Road trip! We're off to Fresno and points beyond for some Customer visitations. So far two customers and two sets of stairs but don't worry - I'm upright and making it look good. What's the likelihood that there will be no stairs tomorrow?
I wish I could have gotten the picture of me standing on one leg trying to iron my shirt in my handicapped bathroom but you're just going to have to take my word that it was something to behold. For you non-ironers, the standard hotel room ironing board doesn't provide much in the way of support so there's "no leaning." I didn't burn a thing and it's lots easier to yell at Jer to fetch something important than for me to do it by myself up here. I may need to think any more trips through a little better until I get back on both feet.
I'm happy to report that there were no more steps required at any of the Customer visits.
You can refer to me as the "Party Animal" - I had three engagements today with two parties and a karate lesson. No, not MY karate lesson, Trey's karate lesson. The two parties included a Birthday Party at the Artura's and a dinner party at the Kelly's of Upland.
Week Seventeen - Sunday, May 3
The rash is gone and the foot is still pretty swollen especially after it's been down all day. I've been concentrating on improving the motion of the toes and that's actually paying off. Ankle motion is increasing but not by much. To be honest I think that I'm a little afraid of the screw. Don't forget - this week we schedule the "unscrewing".
Doctor's visit. It's almost time to give Doc a new nickname - the Man with a New Plan. He lived up to his existing nickname this visit because I was in the process of being dismissed when I asked about the screw. "We're going to leave it in" was the response. Say what? Okay, he actually has a plan it just isn't public yet. He's been jawing with his Ortho buddies and the new thinking is that leaving the screw in is better than the surgery to remove it.
I don't have all of the technical terms but putting a screw where mine is, is a common occurrence, and I'm sure, has a proper name. The problem with leaving the screw in is that it tends to break after the healing process has dropped into high gear. The screw is holding the tibia and the fibula together and as the ankle rotates as the ankle owner heals, I think the screw fails in shear as the bones move in relation to each other. Well, the Man of Few Words has been validated by his peers in his thinking that a broken screw offers no problems and as such, we're leaving the screw in. Don't forget that Warren had a plan for the screw and a cool paperweight.
The outcome of the visit is: 1) another month on crutches, 2) put approximately 1/2 normal weight on the leg, and 3) we're leaving the screw in. So much for being afraid of the screw. Maybe I should name it.
Week Eighteen - Sunday, May 10
I'm not putting much weight on the leg when I walk. I'm using the weak excuse that it slows me down but the reality is that I'm still afraid of it. I failed to recognize the proper use of the pool and thought that I should be swimming laps rather than than using the flotation properties to get .5000000 of the normal weight properly distributed on the stump.
I spent a fair amount of time in the pool trying to walk on the piggly wigglies. They don't want to bend, the ankle doesn't want to bend and after a seemingly harmless 20 minutes, there still wasn't much bending going on. The swelling looked good but it's pretty stiff.
Dang it! I've been joking about it for weeks (about seventeen) and I finally did it - I bought it in the parking lot at Red Robin. I was driving and had gotten out of the car and hopped back to the back door to fetch my crutches. I pulled them out and set them down but before "saddling up" I tried to close the door and when I rocked back out of the way to clear the door, well, I just sort of dumped it. Not many people in the lot and it was pretty dark so I my reputation may have skated on this one. Did I mention that the trip to the gym kicked my butt? I know I said 20 minutes but that doesn't include the 45 minutes of lap swimming while I was there. I really need to pay more attention when I'm tired.
Trevor's graduation party at his family home. It's a multi-level house with lots of stairs. I've been there before on crutches but I'm not thinking that I've been down this particular set of stairs previously. Did I mention that this set has pretty narrow treads? And given the results I don't think that I'll try them again. On the second step down, I tipped backwards but was able to counterbalance with the broken leg so I caught my balance and averted a fall. There are no railings here so I knew that I was in trouble before I took the next step but, with no escape plan I took the step anyway. After one more step I started tipping forward this time so I took another quick step to try to catch up and that turned into two and then I began the checklist for bailout. I jettisoned the crutches and began the search for something on the walls to grab. At the last step I spotted the jams where a door would go and convinced myself that everything was going to be okay. I'd be almost prone by the time I got there but beggars aren't choosers and for three quarters of a second I was ecstatic. My first hand had caught and I was beginning my rotation when I reached the jam with my second hand. It was at this point that I had the cold realization that with less than a half inch of jam to catch I couldn't hang on to it and I was completely airborne.
I missed both my Wife and all of the furniture when I landed but it wasn't very pretty. Nothing injured but my pride but wow, was that embarrassing. As I reflect back I think that the jam being narrow was quite possibly a good thing because, with 207 lbs. on the move, had I caught the jam and held on, I would have likely ripped the jam from the wall.
I'm still finding new bruises this afternoon from last night's crash. Is that a rug burn on my good knee?
I'm off to St. Dorothy's Festival with J. This is normally a drunken brawl so everyone looks forward to it for weeks on end. Trey & I ride on the Bears (think teacups at Disneyland) and spin the red one right off the bearings. This year I had a couple of buddies spot me getting in and out of the bear and once again, they'll need to replace the bearings before going to Holy Name of Mary next week in Monrovia. I only got busted when the Artura's spotted my buddy holding the crutches at the exit of the ride. Where's Pete? Oops.
I learned two things from a conversation this evening - They don't like it when I don't drink & I'm no fun when I'm on crutches. Pretty heavy musings considering the group and the alcohol content. I'm going to withhold the identity of the source of the comments for blackmail purposes.
Week Nineteen - Sunday, May 17
I'd like to think that we're dang near back to normal these days. Obviously they're not, but we seem to be doing pretty normal things these days with dinners out, work schedule, weekend partying, and such. If I have many more weekends like this one I'm going to have to take a couple of days off of work to recover. All that pegging around last night and my gymnastics the evening before left me a little spent, not to mention a little sore.
The leg is better. The swelling is down a little and the motion is up a little. No shoe yet but I'm doing a better job of "walking" on the leg and I'm dirtying lot's of socks :-). I've got a good feeling about my next visit (in two and a half weeks) with the Man of Few Words so I need to spend some more time in the pool working on my motion so I'm ready.
Whoa! Check the stump out! That's right, that's a shoe on it. It's still plenty swollen but it's getting better every day. Don't get the idea that I'm going to start wearing a shoe anytime soon but you can bet that I'll have one on when I go see the Man with a New Plan. I'm obviously going to need both shoes on when I start walking without crutches so I don't go sideways and develop a whole new set of injuries.
Week Twenty - Sunday, May 24
Now that's a nice, busy weekend. Friday dinner with my Mom, Saturday dinner with the Kelly's, a Sunday trip to Redondo Beach to meet up with Mindy, a long time buddy Of Jer's, and a quiet Memorial Day at home.
I'm not going to the gym to swim anywhere as much as I should be but I'm spending a fair amount of time walking on the leg with between 10% and 60% of the weight on it and that's helping to reduce the swelling.
Who's the optimist that thought that we'd be back in action in four months? Alright, that was me. And to be honest it doesn't seem like it's been almost five months so far. When people ask me about un-leg-related activities I often respond "a couple of months" only to realize that it was more like a couple of months BEFORE I broke the leg or six to seven months ago. We have come to the realization that we may need to redo the entire calendar for 2009 specifically all of the vacation days that we have planned. We begrudgingly canceled a trip to Two Harbors on Catalina for our Anniversary earlier this month but it never really occurred to me that trips planned more than six months from the injury date could be in jeopardy.
I've got a serious appointment on a 65' sport fishing vessel in another two months. I can't be on crutches or any kind of "reduced duty" for that endeavor, not because the Skipper would say something but because if I were to fall overboard, they'd just leave me. I've got to be 100% to hang with those cutthroats. The houseboat trip in September is another 100% requirement. I've got to be able to go up and down a ladder and kick with fins - both fins. Stay tuned.
I've been slackin'! A couple of buddies pointed out that the picture links posted last week were broken. I knew it of course, but I kind of figured that I had a couple of days before I needed to remember. Oops. Then, Kevin points out that Untangle, when cranked up tight, thinks that this blog is p0rn for nudity. Oops again. Don't go back opening all of the pictures here looking for the nudity. Violent, graphic or explicit, sure, but you're going to be really unhappy looking for nudity :-).
There's the pain that I've been looking for. I have some experience in broken bones and I'm intimately familiar with the pain associated with the healing process. The break in the bone doesn't hurt but the ankle itself can get a little spicy. There are times when I think that I can feel the screw in there, almost like the ankle is hitting the stops during rotation. I'm pretty sure that it's just my imagination but when I step with more than 50% of the weight it can be a little touchy. I thinking that it's my imagination because as soon as the Doc releases me for sky diving on Wednesday, I'll be able to walk just fine without any head tripping.
Week Twenty One - Sunday, May 31
We're just a couple of days away from the next Doctor visit so I'm ramping up for some additional mobility. I'm driving Jer's car using my right (broken) foot and I'm trying to concentrate on full ankle motion as I walk, all the while putting 1/2 the weight on it. The swelling is down a little but there are days where it can look like it's still in the cast. It's a little slow to warm up and remember how to bend but typically by the end of the hall it's back in the groove. We should get some more xrays on Wednesday so we can really see some healing :-).
Doctor's visit today!
We're a week short of five months and we've been released for full weight! The MFW, not to be confused with The MNP, actually laughed when I asked if I could walk home! His point was that yes, I _could_ walk but he didn't think it likely that I would _want_ to walk with the shooting pains that were going to occur when the ankle got wind of me walking and bringing me to tears.
There appears to be some spare "stuff" floating around in there. Do you see the wayward staple? How about the spare bone chip? At this point I'm just glad that he didn't try to screw the bone chip to the plate with the rest of the debris that he found lying around the OR. You can see a couple of staples in this xray that look a little lost but rest assured - they've been found. Do I need to mention that he doesn't seem to be the least bit surprised upon seeing the staple and the chip? I didn't think so.
Next visit is in six weeks. Tasks to work on: 1) drive the 5 speed, 2) take a shower, 3) get some more motion, & 4) get some swelling out of there.
Jer innocently (shh! not now! Don't interrupt me here for a minor correction like that) asked if I could drive. That's not as funny as me asking, just as innocently, if I could ride a bike. If you've ever ridden with me then you'll see the humor there, but I digress. He loved the idea of riding a bike so I'm off to InCycle for some shin pads. I already have elbow pads (because I got tired of leaning on road rash at my desk) but this is different. I wouldn't want to knock any of those spare parts in the leg around, now would I? And no, I'm not going back to comment on my driving :-).
Whoa! Who besides me, thought that it was a good idea to walk on the stump? I seem to recall someone thinking that there could be trouble if I were to attempt such an endeavor but I can't recall whom.....
So Jer comes by to pick me up on the way to the market after work. I've been padding around the office in my socks (the shoe doesn't fit all that well just yet) all afternoon so I'm ready to go and walking around the market sounds like a good idea. It's a nice, slow pace and while I didn't think of it at the time, you can hang on to the cart for stability. The biggest drawback is that the shoe doesn't fit all that well just yet but I can get it on so on it goes and off we go.
About the time that we're heading back to the car I decide that the stump has had about enough and I'm prepared to call it a day. I'm on barbecue detail but that's pretty easy duty and again, a nice, slow pace but it's raining so I really need to leave the shoe on.
I wrap up the bbq detail and entrench on the chair where I've spent the last four months and, at long last, take the shoe off. The stump seems happy and there are no protruding parts (one can't really take anything for granted if you know what I mean) so I rest the foot on the floor and we watch the USA Men's National Soccer team get, well, a butt-kicking by Costa Rica in Costa Rica. I'm not all that surprised but some of those around me might be :-). Then I try to stand up. (The obvious joke here is "now who's laughing?")
Okay, I didn't go to the floor and I didn't cry but I _may_ have winced maybe a little. I can drag this out a little (probably a lot) longer if you like so let me cut to the chase. I decided to sit in the tub and get some heat in the joint and that means a trip up the stairs. No problem yet. I get out of the tub and trek back downstairs to where all of the action is and re-take my seat in the chair. Still okay. I was even able to make it back up the stairs and get into bed. It was when I got out of bed and tried to walk to the bathroom that it caught up with me.
So today, the following day, I'm back on crutches. I can walk - alright, it's more like a hobble - around my office but if I need to travel long distances, like more than twenty feet, then it's on crutches. The leg a little painful to stand on in general and the ankle bends although not well but the motion caused by walking is a problem. The ankle is not swollen nor is the foot (I have the shoe on) but the entire lower leg is swollen. The foot actually looks better than it's looked in a while.
Is someone going to point out that I didn't break the foot, or even the ankle? That's what I thought.
I'm doing better but definitely not best. I stagger around but I'm not getting very far from the crutches. The swelling is about the same. Not a lot of time on the foot and I didn't even try to go to lunch without the crutches. The ankle feels okay just as long as I keep any weight off of it.
The last couple of days have been tough going but I knew that it wouldn't be easy. The biggest problem in my mind was that fact that my knee (same leg as the break) has been bothering me and I wasn't really sure why. I wasn't sure until now.
I'm surrounded by Trainers but it apparently hasn't occurred to any of them that the ankle isn't going to be the problem. The knee is the problem and I don't know why this didn't occur to me before. The ankle doesn't need a lot of strength to walk and even in its most relaxed state it will support weight without collapsing. The knee isn't like that. Some of you will remember that I've rehabbed a knee before so I learned some of this the hard way. Well, it finally occurred to me that unlike the ankle where getting motion back will come with normal use, the knee is not that way. Without putting some strength back in to the knee I can hardly stand, up much less walk. Today the reason that the knee hurts hit me like a ton of bricks and the two tools that I need are the two tools that I had but have gotten rid of - the knee machine and a stationary bike. Back to the gym and I feel better already.
I've already got a short seat post (left over from a previous bike frame) that drops down to the perfect height for me - total downhill height :-). My idea of downhill right now is limited to my driveway but that's a different story. I can putt around the neighborhood at a nice, leisurely pace and put both feet down without needing to hop out of the saddle. Think beach cruiser with six inches of travel :-). OR, a stationary bike that moves.
I took the 5 speed for a test drive and have been released for full driving privileges by the driving instructor. I think that may be the biggest relief to both parties yet. Apparently I'm not a very good passenger.
Week Twenty Two - Sunday, June 6
That was a nasty couple of days but figuring out what was going on is a huge relief. The shoe goes on easier each morning and hobbling is down to a serious limp. Okay, it's a pretty serious limp but damn it, it is _not_ a hobble. Back to the market for another training workout on the cart and then a trip around the 'hood on the stationary bike.
Who doesn't stink now? That's right, I'm back in the shower! My neighbors are going to be happy about that, let me tell you. Not because I'm particularly stinky but because I'm not bathing in the kitchen sink. Let's just say that it's a friendly neighborhood.
Week Twenty Three - June 14
My walking isn't any better but the swelling of the leg is way down. I've been riding my bike around the neighborhood and all of that motion is having a profound effect on the swelling. The motion is good in the ankle and the foot is looking almost normal. Well, almost normal in this context is still swollen but the toes look like toes and the shoe goes on pretty easily.
I can walk without crutches some during the day but early in the morning and later in the day is pretty rough. The knee is better with the added motion from the exercycle but now I need to turn up the heat for some strength. I may need to actually go to the gym for this. The most immediate problem with tat is going to be the 1) busy nature of the machines at the gym and 2) the fact that all of the cardio machines are upstairs. Hmmmm.
After about an hour and a half yesterday on the bike, my knee is not happy. I've almost convinced myself that I damaged the knee during the fall and just hadn't noticed until now with the addition of some weight. It's sore to the touch, doesn't want to bend, and nothing that I do seems to ease the pain.
Is that the same knee? If I were to put some of those little metal clips in my hair you'd think I was on the gymnastics team. Okay, I may be over the weight limit and I might have a difficult time getting the leotard on, but just the same, the knee feels great.
The knee held up okay until about noon before retreating to the crutches. You need to remember that I use the crutches in the morning at the house and in the evening. It's the work day that I'm referring to when I say that I was on it all day.
The knee is a little sore today so we're keeping the crutches very close.
The knee is about the same today as yesterday. The leg is okay to stand on once I warm it up. Off to the Market Broiler for some fish for the dual-birthday-dinner-party for the two Birthday Girls. The Market Broiler is next to the theaters at the Ontario Mills Mall and it is days like this, a typical Friday Night at the theater, when I think that maybe I should have hit the MFW up for a handicapped parking permit.
Maybe I should get over myself on this issue of "handicapped parking permit abuse" but I'll tell you, it's a real sore issue with me and I'm paying for it now. I see people get out of vehicles with DP plates (obviously permanently disabled) that don't look all that disabled and then I see my buddy, the "Fingers of Death" who is so far beyond permanently disabled that it isn't even funny and he just carries a placard. It is obvious to me that this is a contest on who has the better Doctor. As a result my Doctor and I have not had the conversation and to be perfectly honest, I would expect him to look at me, laugh, and then say something like "how are you going to fix that leg if you don't walk?"
What do you know? I was able to peg over to the restaurant and back just fine.
I know that it's been a while but I finally pulled everything out of the garage and swept the entire floor. You can imagine that there _might_ have been some remaining Christmas decorations under and behind some of the stuff that sits in garages but not any more. That floor is spotless!
We're going to try some ice on the knee and the leg on a more regular basis. We been using a couple of bricks for the last week and I'm seriously entertaining the idea of picking up the pace. Besides, it keeps my ice cream colder longer while I'm watching TV.
Week Twenty Four - June 21
We combined Father's Day with Jer's Birthday and got the entire gang together over at Yord's. Very nice.
Back on the bike for about 15 minutes - at least it didn't hurt the entire time.
Feels pretty good today. Actually I spent the entire work day on it and had some left over. Up to and including Taco Tuesday at Norm's Hanger out at Brackett Field Airport.
Feelin' good again today. So far, I'm up on it without issue. I will mention here that there is some pain and it's right above the ankle, exactly right where you would expect it to be. It's enough so that when it comes in I get off of it and pronto. The swelling is down far enough that you can tell that the calf is a calf - it actually has some definition - rather than just a stump. The ankle is swollen enough so that if I take the shoe off I have to wrestle it back on.
Another good day that includes all day up and down on the leg up to and including dinner at the Artura's. We poked and prodded and twisted and turned and came up with some new exercises for increased motion. Someone _might_ be a little concerned about the residual swelling at the ankle. So concerned that I have a follow-up appointment scheduled :-).
Pretty good day again with a full day of up and down. I must say that all of this end-of-day icing is affecting the hardness of my ice cream in the freezer. Do you think that the Health Plan will approve an ice-only freezer to fix this?
Week Twenty Five - Sunday, June 28
Overall swelling is down. The calf is getting some definition and the ankle is almost recognizable as an ankle - I can actually find the ankle bone! This is the first time on the stationary bike (at the gym) that I have put some resistance on the ride - 15 minutes at level 8. Lot's of walking today and even some bike riding in the neighborhood so when the Drags came on I was moving pretty slow and when the Galaxy game came on (1900 hrs) I was fully iced in the chair. Did you happen to watch the Boys in Blue? Yowsa!
Feels pretty good today so I'm just going to leave the crutches in the car at work. I even left them at home when we went to dinner so I carried them up the stairs at bed time.
Feeling good today. So good that I headed down the stairs carrying the crutches. I'm still staying off of it in the morning until I can get in the shower and get it warmed up and that seems to be the gating factor to dumping the crutches. My goal is to be off the crutches (give them back to their owner) by the 8th of July. We'll see.
There is no way that I'm going to be off of the crutches by next week. It feels okay in the middle of the day but first thing in the morning and after it's been iced in the evening, no way.
Long holiday weekend here. I'm not out mowing the lawn but I am barbecuing and I'm walking around with no cane.
Week Twenty Six - Sunday, July 5th
The crutches are parked. I used them last night but I got brave this morning and haven't looked back. The swelling is down enough that even my "regulars" that say each morning "Is that supposed to be that swollen?" are saying "Wow, the swelling is down." To be fair, there is a section of the leg, from the wound to the top of the foot, where it feels like it will never go down. It's just solid in there so I'm figuring that it's all scar tissue.
Jer threw me a bone and we went to see Transformers, The Revenge of the Fallen. I had a nice picture to prove it but it got deleted some how, right off my camera. Hmmmm. A little short on plot but long on effects so I'm happy. Did anyone else happen to notice that all of the good guys are Chevrolets? Who says the sixties aren't back?
No crutches this morning. I'm not brave enough to give the crutches back to their rightful owner just yet but if I can go five or six days like this then consider them gone. The crutches are down stairs at home but they are at home just the same.
Yesterday I cranked up the torque on my bike and got out of granny. No out-of-the-saddle sprinting but some torque just the same and I'm feeling it today.
Not so good today. I'm finally prepared to admit that I'm sick and that the sore throat isn't from screaming at a soccer game. This has been nagging since Sunday and it has finally taken its toll. I can't tell one feeling from the other so I'm throwing in the towel and going to bed for my icing at 8:00pm.
Better today. A little Nyquil and I slept like a baby. Still no crutches and the ankle feels better. I'm limping but there's no real pain associated with walking.
I played it safe and didn't exercise yesterday and I feel pretty good today. The cold is pretty much gone so that is a non-issue and I'm moving at about normal for these days.
After a Club Sandwich from Angel's and the rather lengthy walk back to the car I notice that I'm getting some (this is _the_ first) heel-to-toe roll as I walk. It's in a very limited range but it's a roll! I'm almost walking again.
The ankle feels good today. I'm walking better and I recover quicker when I add weight in an attempt to stand. We have a dinner date tonight so Jer has asked me to take it easy today so I'm not a basket case tonight. I guess that means no balance beam workout today. We're off to Off Citrus with the Kelly's of Upland for dinner. We have never been there before and we've got a reservation for the patio so we should be fine.
Week Twenty Seven - Sunday, July 12
This was a big week in the healing process. It included my first step with a heel-to-toe roll and a return to normal wardrobe change. I've gone back to wearing my normal socks on both feet rather than the "big and tall" sock on the broken ankle that I had adopted. I'm exposing some nasty scarring but as Waldo's personnel Vet pointed out, the sock was limiting the circulation under the elastic band.
The swelling is down considerably throughout the upper and middle region of the lower leg. You can now identify the atrophied calf muscle as a calf and not just a stump. The swelling in the foot continues to go down as well so it's just the ankle region that needs (significant) work.
Don't forget that we're off to the Doc's this week for a six week check-up.
I may have added to my aggravation today by getting a little snippy with the Deputy bent on keeping me from getting home. For my trouble it got me a ticket with a couple of infractions on it. I'm so fired up I'm going straight home and watching NCIS reruns.
So, the Doc was pleased and gave me my final release today. In the process, I learned two things: 1) This was a "profound" fracture, and 2) there was some serious damage to the circulatory structure at the exit point. You're going to need to wait for the proper definition of a profound fracture but in layman's terms it refers to damage to all of the bones and surfaces in the region of the ankle. I guess that explains why the MFW was tickled pink each and every time we looked at xrays. Do you remember when I said that the Doc couldn't care less when I pointed to all of the other areas of the leg and he kept returning to the surface of the ankle? Well, now we know why - it's been reconstructed! No wonder he's so dang proud.
The circulation damage explains why the ankle remains swollen and may even stay swollen. He thinks another six months will show it at its best but it is never going to look like the other ankle. He put some torque on the ankle forcing the foot up and after I winced he pointed out that I need to continue to work on the motion. He doesn't expect full motion to return but he expects more than we've got today.
As we are saying our good-bys I realize that he doesn't want to see me again so I ask "do you want to see me again?" He smiles and waves with a flourish over his head and says "Come back any time!" What a kidder.
On the way back to work, Jer & I stopped for lunch at a new (for us) Mexican food place. While dining there in walks the staff from the Doc's office. I pointed out that we should have carpooled but they remembered me not from my most recent visit (15 minutes prior) but from the time that I bled all over their carpet when the Doc pulled the pins out. Lucky I'm not going back :-).
Week Twenty Eight - Sunday, July 19
The color has returned to normal in the leg so whatever that was about seems to be gone. The swelling in the ankle is nominally the same and my stride is improving daily. There's still a significant limp and there is no speeding without retracting the foot and hopping.
I nabbed a couple of 2x4 rems from the Home Depot while we were looking for hinges for the kitchen cabinets. I've set them (the rems, not the cabinets) under my desk to help stretch my calf and to get some additional motion in the ankle. Now, I can stand at my desk while I chat on the phone with my toes on the board and my heels on the floor. Stretch calves, stretch!
I've returned the crutches to their rightful owner with all new arm and wrist pads and a new set of anti-slip feet - I only wore out two sets of feet in five and a half months!
The August fishing trip seems to be in serious jeopardy at this point. There's no way that I could stand from 6am till 8pm on a pitching deck the way I am now. Let's revisit this in another couple of weeks. I talked to Warren today who was just back from the first fishing trip of his season - 150 miles down to the fish. That's a boat ride! They traveled so far that the boat had to leave early so they could start fishing before noon. To be honest, the distance to the fish has no bearing on my ability to travel because only the fishing time counts. If there are no lines in the water then I can sit in the galley or sleep in the bunk.
Week Twenty Nine - Sunday, July 26
The swelling is down a little more and the large scar is a little less pronounced. My walking is better but still labored and as such, I've decided that I need to spend more good, quality time on that. We walked all the way through the San Dimas Car Show, so maybe a half mile and I was spent. A little ice down while watching the USA Men's National Soccer Team show up but fail to play the second half of the game against Mexico. Mexico looked sharp and they really punished us but strangely that didn't seem to make my ankle feel any better :-).
Later this evening we took a walk around part of the complex, maybe a quarter mile, and the ankle was in good form. It looks like I need to get out and walk more!
The ankle is a little tender this morning. It's walking okay but it's definitely a little slow. Did I mention that I crawled from the bed to the bathroom rather than walk in the middle of the night? Let's see if that becomes significant.
Not too bad today. In the late afternoon I was doing some stretching with my 2x4s and when I got up to walk it off I could hardly walk. The outside of the ankle is, well, painful. I don't give it much thought because we're off to Orange County so I can get my hair cut. By the time that I get in the chair I'm having a tough time getting it comfortable but I can suck it up. We normally go to Chili's for dinner in Yorba Linda afterward so off we go. I can hardly walk across the parking lot but to be blunt, that is more common than I'd like to admit these days. Each trip across the parking lot has taken longer and longer since I left work and the one back to the car from Chili's is probably my last judging by the grimace on my face.
I'm holding it together and even manage to find a comfortable spot to rest it while I drive home. When we get home I manage to get through the garage on my own but I'm crab-walking up the stairs to keep some of the weight off of the ankle. I go straight to bed where we're going to ice that baby up and wait for Jer to tote all of my icebergs up in the bucket.
When she pushes the blue ice up against the outside of the ankle I yelp and sit straight up in bed - I think we found the problem. A closer examination reveals a large lump right at the bottom of the surgical incision and it pretty painful to the touch. It's bad enough that I'm going to call the Doc in the morning.
The Doc's office reports nothing for me today but I can get in tomorrow at 9:45. Booked!
Thursday - Disaster Strikes
Jer was going for infection and I figured the Fibula was broken but even the Man of Few Words is speechless with these pictures although he guessed the problem correctly by wiggling the ankle.
Bottom line is that the big break didn't heal. The technical term is that the fracture is non-union. There are three factors to consider with bone healing: 1) the commuted nature of the fracture (sticking out of the skin) and the exposed bone dying with no blood circulation, 2) the lower section of the tibia where there is less circulation anyway, & 3) the many fragments of bone with the same lack of blood flow being pieced back together.
All of the other breaks seem to have healed just fine. Apparently all of the pins each held one of the large pieces of bone together in the original glue-back-together and everything stuck together with just one, small exception.
One Monday I have an appointment with a different Orthopedist, albeit in the same office, for a second opinion. Don't worry, we'll get a second nickname for the second Doc. The two Docs are going to chat before then and then he and I can chat to discuss our (my) options. Bone grafting came up in our conversation today, from either a hip or the bone donor bank, to replace some of the dead, non-healing bone. I would think (although I'm not an Orthoped) that a rod or a plate is the likely solution here. Maybe I'm just used to playing in the machine shop so everything looks like machine shop problem.
Get out the calendar - we're rescheduling everything! August fishing trip? Canceled. Houseboat vacation? Canceled. Even a soccer game at the Rose Bowl this Saturday night, canceled! This was a tough one for me. Three days ago I was worried about being able to walk that far in general. Yesterday I was worried about being able to deal with the seats knowing that the leg is broken. I know that I can peg that far on crutches. Now I'm afraid that going to the Rose Bowl is not such a good idea at all so I'm bowing out of that too. What a wimp.
I'm back on crutches full-time putting zero weight on the break. Okay, I _might_ put down a toe to steady myself while transitioning but that's it, no weight. I was in pretty good shape on the crutches but that was three weeks ago and the calluses are all gone. When I got home from dinner and settled in for the evening Jer checked for messages and there were three but only two were of immediate interest. At 10:08 that morning the Man of Few Words called to say that he's concerned that there could be an infection that we have missed and he's writing an order for some blood work. He'd like the results available on Monday when I see the Consult. At 10:32 that morning one of the girls from the MFW's office called to tell me to come by to pick up the order for some blood work.
Well, needless to say that when I called Saturday morning there was no one in the office and none of the three Docs in that office were on call - a leg breaker from Covina was doing the covering so that was a dead end. When I go in Monday morning maybe they'll send me over the Hospital for some stat work.
Week Thirty - Sunday, August 2
Not much need for a weekly update here. I can comment that I missed not just the Galaxy game but a 35th High School Reunion last night. Instead, I was sitting comfortably in my chair watching taped episodes of the Closer. I've decided to forgo any excess motion or weight on the leg since I now know that it's broken and that means that I'm not driving. I've parked my car and decided not to try and drive Jer's, even left-footed because of the angle that the broken legs rests at. When the Doc wiggled the foot and I saw how the lower leg rotates at the break, I decided not to relax in that same position. No sense putting undue flex on the fibula (let's leave it in one piece.)
When the leg is in an unsupported resting position the foot tends to settle with the toes pointed away. There's no pain but I'm a little worried that it's going to sort of break off.
Doctor consult visit. Did I mention that we got the trauma guy this visit? So, while the emergency repair was fine we probably didn't have the best approach for the recovery process. The new guy is the Chief of Surgery and the ex Chief of Staff at Foothill Presbyterian. He's the trauma guy in the office and apparently the one that my Doc called before surgery to vet his approach. He was out of town at the time but he recalls the conversation and while my result might have turned out differently there always would have been a second surgery.
So, the bone is broken but not in the sense that it's in two pieces but more like the growth is preliminary and consists of scar tissue and cartilage and is around the break, kind of like a rubber joint. It hurt because I aggravated it but now that I'm not walking on it there is no pain and the swelling is way down. The break is not going to come apart but we're going to keep the weight off of it for a while. He wiggled the break area and seems to think that it's well, rubberized. So, continued motion, little weight, & crutches.
There is an alternative to surgery. It consists of using the bone growth stimulator for eight weeks, getting the joint healed and moving on with life. The 10 or 12 degree angle of the tibia where it connects to the ankle is a matter of some concern because of the bearing surface at the ankle. Over time, a wear pattern like this will create an undesirable condition that is very likely to lead to a fused ankle. While I'm not still playing soccer or chasing kids around the yard I'm not quite ready to deal with a ankle that doesn't bend. At all.
So the plan is this:
- Perform blood work to determine if there is a low grade infection. We added a blood test to the existing order for two so I came home with two band-aids, one on each arm.
- If there is no infection, we schedule surgery at Foothill Presbyterian. We straighten the ankle and install a top secret plate designed just for this very type of break. Two days in the hospital and back to recovery. Remember the paper weight? Well, that big screw (~$120) is coming out to make room for the seven new screws that hold the bottom part of the plate to the end of the tibia.
- If there is infection we consult the contagious infection boys for the best approach and deal with that, all the while using a bone growth stimulator at night. Once all of that is good then we perform the surgery.
As you all know, whenever there is an injury involved, everyone has acquaintances that have been through this previously and come complete with war stories. To be honest, I may be one of the worst offenders. Well, there's a guy that frequents the Coffee Klatch that has been touting this Jules Vernes contraption (we now know it as a bone growth stimulator) for a couple of months. While I didn't say anything about it I'm pretty sure that inside I was rolling my eyes. Well, who would that be laughing now?
One of my healthcare advocates has given me some insight on how the bone has managed to heal like it did:
So I'm thinking the MFW was working his way from top to bottom, putting the pins
in. He runs out of pins with one bone fragment to go, so he uses a gummy bear
instead. That's how I account for the rubbery feeling.
People! This is how problems get solved! Thinking outside the box and applying real-world solutions to out-of-this-world problems. Nicely done, Tom.
I can't believe that I fell for it. The new Doc's line of "I'll call you when I get the results." Well, here it is Friday, the results are on his desk, he's reviewed them, but he's not around. Until Monday. Wait! What's another three days when I measure time with a resolution of a "moon."
Week Thirty One - Sunday, August 9
We're in hurry-up-and-wait mode here. The results are in and we're, well, not in the know. Do I need to mention that my Mom is a little bit miffed?
The foot and lower leg are pretty swollen by the end of the day. There is no pain associated with the break (remember, I'm not walking or standing on it) so I'm just getting better on the crutches. I say that but I'm not sure that I mean it. Just last week I tipped over right in front of Cordell. I was pretty stealthy but for some reason Bill looked out his window just in time to see me splayed in the parking lot and probably thinking something like "I wonder what he's looking for down there?"
I'm on the phone at 9:02 looking for the Doc with no nickname. He's no where to be found but she's keen on his ways and knows not only where to look but she remembers speaking with me last week and taking a message for me. There is no word yet but the day is young.
10:30 am brings much the same results with one change, he's in. She's going to string yellow caution tape across his office door and see if she can get his attention that way.
I mention to Jer my progress so far and that I'm going to try again this afternoon and she does nothing but laugh. Have you learned nothing? Are you not paying attention? Could that maybe be what you called a plan of action on Friday? How did that work out for you?
11:30 am brings similar news: he hasn't responded to the yellow tape barricade so we don't know anything.
14:30 pm brings some good news: the Doc has been working on it. It's not done and he's not there but it is in motion. We can derive from this that there is no infection and I guess that is good news. I'm to call on Wednesday to check status but the real break is going to come when we can move the paperwork off of his desk and on to the scheduler's desk. Maybe tomorrow.